1. An Unexpected Outcome: learnings from the evaluation of training for a Tele-Check program Professor Judi Walker University of Tasmania

2. What is Telecheck?  Tasmanian Tele-Check suicide prevention program designed to improve the capacity of a community to respond to people at risk of suicide  Idea originated in northern Italy – TeSAN.  Service providers/others identify people who may be at higher risk of suicide.  Local trained personnel – ‘Tele-check operators’ use the phone to check regularly on the health of individuals.

3. What is involved?  Informing professionals about the program  Recruiting and training local Tele- Check personnel  Developing referral, assessment and feedback protocols  Embedding Tele-Check into existing local service delivery systems

4. Tele-Check should…  Extend and enhance an understanding of suicidal behaviour  Enhance inter-agency response to suicidal risk  Tele-Check is proactive in its response  Personnel contact those clients referred to them rather than respond to a consumer initiated call.

5. Tele-Check provides …  A strengthened social contact network  A regular check on the treatment plan  Inter-agency linking for further referral or crisis response  An improvement of the community capacity to respond beyond the clinical setting

6. Where?  West Coast Tasmania  Geographic isolation  High rates of suicide and attempted suicide  Economic downturn  Mining – copper, tin  Tourist boom hasn’t happened  Decreasing population  Centralisation of services  The Rosebery “experiment”

7. Tasmania Tasmania’s strength and weakness is its rurality and isolation. It offers a unique environment as a model for successful rural health initiatives

9. Remote communities  Shortage of skilled health / social welfare staff  Limited specialists  Limited resources and support services  Difficult access and communication to services

10. Our focus is on the evaluation of the Tele-Check training program (service providers and Tele- Check personnel) and its implementation

11. The evaluation revealed that all those involved understood  patterns & trends in the incidence of suicide & self harm  suicide behaviour and correlated individual, family & social factors with risk  about social connectedness & well being and how this is associated with social structures & networks  That proactive contact has a positive effect

12. But most participants were confused about the nature of the Tele-Check program and how it could be implemented in their community

13. What have we learned?  There is major confusion about the Tele-Check concept  Trainees thought it was (wanted?) a new service not an enhancement/network for existing services  We need clear marketing & communication about Tele-Check before training personnel  What is clear to us may not be clear to local stakeholders  This lessens the impact of the innovation